FAQs and Information

Am I Eligible?

ICHS PACE is an innovative model of care that helps seniors live independently in their community. The program is open to anyone:

Age 55 or older
In need of nursing home level of care as defined by the state of Washington
Residing in the PACE service area at the time of enrollment
Able to live safely in the community with PACE services
Medicaid-eligible and/or willing to pay private fees

How Do I Enroll?

There are three steps to enrollment that will help us determine if a PACE program is right for you.

An enrollment specialist will meet with you and your family member/caregiver in your home to gather information about your medical care and needs.
You will visit our PACE center to take a tour, meet staff and ask questions. An interdisciplinary team will review your medical history to help determine if PACE is a good fit.
Upon approval, we’ll invite you back to the PACE center to discuss your personalized care plan and finalize enrollment.

Give us a call at 206.462.7100 to speak with an enrollment specialist and learn more.

What Is The Cost?

The ICHS PACE program accepts enrollees eligible for Medicare, Medicaid and/or private pay. Your participation in PACE is fully covered with no need to pay out-of-pocket expenses if you are eligible for both Medicaid and Medicare. Some Washington State Medicaid enrollees may be subject to a “cost of care” amount if they are receiving long-term services and support. Your enrollment specialist will discuss costs based on your eligibility. You may be fully and personally liable for the cost of unauthorized services, other than emergency services.

Rights and Responsibilities

If for any reason, you do not feel that the PACE program is what you want, you have the right to leave the program at any time. You will be disenrolled from the program effective the first of the month following coordination of insurance benefits.

Grievances and Appeals

As a participant of ICHS PACE, you are encouraged to express your concerns, to file an appeal, and to submit a complaint verbally or in writing at any time without fear of reprisal from our staff.

Grievances
A grievance is defined as a written or oral expression of dissatisfaction with medical or non-medical service delivery or the quality of care provided by ICHS PACE, or our contracted providers. Please click here for more information on how to file a grievance.

Appeals
An appeal is an action you may take, whether verbal or in writing, to dispute a decision by ICHS PACE regarding the non-coverage of, or non-payment for a service. This includes service request denials, service reductions, or termination of services. Please click here for more information on how to file an appeal.

To file or check the status of a grievance or appeal, PACE participants or their designated representative may notify any PACE staff member in person, or submit the request by telephone, mail or fax:

International Community Health Services – PACE Program
Attention: PACE Quality Administrator
803 South Lane Street
Seattle, WA 98104
Fax: (206) 962-3301
Phone: (206) 462-7186
After Hours: (206) 462-7100
TTY for the hearing impaired: (206) 788-3774

Appointing a Representative

If you would like to appoint a person to file a grievance, request a coverage determination, or request an appeal on your behalf, you and the person accepting the appointment must fill out the Appointment of Representative Form 1696 here (or a written equivalent) and submit it with the request. Your prescribing physician or other prescribers may request a coverage determination, redetermination or IRE reconsideration your behalf without having to be an appointed representative.

Participant Forms

ICHS is required by law to maintain the privacy of your health care information, to provide you with a notice of our legal duties and privacy practices, and to follow specific, mandated information practices. You have the right to receive a copy of your health care information, with some limited exceptions. Below are links and information related to your participant rights, privacy and health care information requests.

PACE participant bill of rights